ICSI clinics in Germany, Austria, and Switzerland

Compare ICSI clinics in Germany, Austria, and Switzerland. How ICSI works, when it makes sense, what it costs, and how it differs from IVF.

152 ICSI clinics compared

According to their own information, 152 providers in Germany (117), Austria (17), and Switzerland (18) offer ICSI. Sort by distance from your location and ask about costs and appointments. By city: Berlin · Munich · Zurich · Vienna · Hamburg · Stuttgart · Basel · Cologne · Frankfurt am Main · Düsseldorf · Münster · Ulm · Erlangen · Graz · Lucerne · St. Gallen.

This page covers Germany, Austria, and Switzerland.

In ICSI (intracytoplasmic sperm injection), a single sperm is injected directly into an egg under a microscope. The procedure is part of assisted reproduction and, according to the German IVF Registry (Deutsches IVF-Register, D.I.R.), is now the most commonly used fertilization method in the lab in Germany.

In conventional IVF, the egg and sperm are brought together in a dish and fertilization happens on its own. In ICSI, the embryologist carries out this step in a targeted way. That makes ICSI the established method when sperm quality is severely impaired. Without male factor infertility, however, ICSI offers no advantage according to large randomized trials. The evidence is covered in detail in our comparison ICSI vs IVF.

When is ICSI recommended?

Guidelines and professional societies such as the British NICE (2026), the American ASRM (2026), and the European ESHRE recommend ICSI mainly in these situations:

  • Severely impaired sperm quality: low concentration, reduced motility, or abnormal morphology. NICE advises considering ICSI depending on the severity of the findings.
  • Surgically retrieved sperm: after TESE or micro-TESE in azoospermia
  • Previous IVF failure: when no eggs, or only very few, were fertilized in a conventional IVF cycle
  • Cryopreserved sperm with low motility: Thawed samples often lose motility. What matters is how many motile sperm are left after thawing. According to the authors of the Danish INVICSI trial, it is not proven that frozen sperm alone requires ICSI.
  • Thawed eggs, for example after elective egg freezing: According to ASRM, ICSI is considered the best-established method, even though the data are limited
  • Planned preimplantation genetic testing (PGT): ICSI is preferred so that no maternal cells and no paternal genetic material outside the embryo can skew the test result. For PGT-A without male factor infertility, however, ASRM sees no advantage.

Having few eggs retrieved, on the other hand, is not a reason for ICSI: Without male factor infertility, ICSI improves neither fertilization nor the live birth rate when there are few eggs, a low ovarian reserve, or older age, according to ASRM (2026). ESHRE and NICE also advise against ICSI without male factor infertility.

In Germany, considerably more ICSI cycles than conventional IVF cycles are now performed. According to the German IVF Registry, about two thirds of fresh fertilization cycles in 2024 were ICSI (66.5%, or 69.1% when mixed IVF/ICSI cycles are included).

The ICSI treatment process

The process is largely identical to an IVF treatment. The difference lies in the fertilization step:

1. Hormonal stimulation

As with IVF, the ovaries are stimulated with hormone injections so that several eggs mature. How many days this takes depends on your protocol and on how the follicles grow. Regular ultrasound and blood tests monitor progress.

2. Egg retrieval

The mature eggs are retrieved under sedation through ultrasound-guided follicle aspiration, a short outpatient procedure.

3. Sperm preparation

The semen sample is processed in the lab. The most motile sperm and those with the best morphology are selected. In azoospermia, surgically retrieved sperm (TESE/micro-TESE) are used.

4. ICSI: the microinjection

This is the key difference from IVF: A single, carefully selected sperm is injected directly into the cytoplasm of the egg with an extremely thin glass needle (micropipette). This step requires the utmost precision and is performed by specialized embryologists. Each mature egg is treated individually.

5. Embryo culture and transfer

Further development proceeds as with IVF: The fertilized eggs are cultured in the incubator for 3 to 5 days and then transferred into the uterus. The due date is also calculated the same way after ICSI as after IVF. The IVF Due Date Calculator shows you the usual time window for the blood test, the week of pregnancy, and the due date, and your clinic will tell you the exact test day.

Success rates

According to the German IVF Registry, the fertilization rate per treated egg in 2024 was 66.4% with ICSI and 56.2% with conventional IVF. Because ICSI injects only mature eggs, IVF is slightly ahead per retrieved egg, however (55.3% versus 52.5%). Pregnancy rates per embryo transfer are largely in line with those of IVF. Clinical pregnancy and live birth rates per transfer for ICSI in fresh cycles (analysis of 2019 to 2023, with mixed IVF/ICSI cycles counted as ICSI):

Age Pregnancy rate per transfer Live birth rate per transfer
Up to 29 40.4% 32.7%
30 to 34 38.2% 30.4%
35 to 39 30.2% 21.5%
40 21.8% 13.0%
41 19.3% 10.8%
42 14.7% 7.3%
43 11.3% 4.7%
44 8.1% 2.9%
45 and older 3.8% 1.1%
All age groups 31.4% 23.3%

Source: D.I.R. Yearbook 2024, p. 27. The key point: Without severe male factor infertility, ICSI does not increase the chance of a live birth, as large randomized trials and a 2026 meta-analysis show (Kayimu 2026). What ICSI improves is fertilization when sperm quality is impaired: With moderately impaired semen analysis results, ICSI fertilized about 1.9 times as many eggs as IVF in an older meta-analysis (Tournaye 2002). In ICSI cycles from 2020 to 2023 with fewer than 1 million sperm per milliliter of ejaculate, the live birth rate per transfer in the registry was 23.6%, and 23.2% after TESE (D.I.R. 2024, p. 37).

Costs

Germany

An ICSI treatment is somewhat more expensive than conventional IVF because the microinjection step is more complex. For the Netherlands, the European professional society ESHRE cites about 8.3% in additional costs. In Germany, clinics with an approved treatment plan bill at statutory health insurance rates, and self-pay patients are billed under the German Fee Schedule for Physicians. There is no fixed price per attempt. Bills differ from clinic to clinic, and the medications for stimulation come on top. Our cost calculator works out your out-of-pocket cost.

  • Statutory health insurance coverage: Statutory health insurance funds pay 50% of the costs approved in the treatment plan for up to three attempts (for married couples, both at least 25, the woman under 40, the man under 50). IVF and ICSI are paid for only as alternatives, not three attempts per method. Insurance pays for ICSI only when there is an indication under the guideline of the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA), such as a severe male fertility disorder, documented by two semen analyses according to the WHO manual and an andrological examination. Exception: After a complete fertilization failure in the first IVF cycle, insurance still pays for up to two ICSI cycles.

Austria

The IVF Fund (IVF-Fonds) covers 70% of the costs, for up to four attempts. ICSI is funded the same way as IVF, and there are separate rates for each method. A prerequisite is one of the indications laid down by law: fallopian tube damage, endometriosis, polycystic ovary syndrome (PCOS), or male infertility. Medications are included in the fund rate. According to Austria's Ministry of Social Affairs (Sozialministerium), one ICSI attempt for women under 35 costs €3,594.54 at a public contract hospital, and the out-of-pocket share is about €1,078. At a private contract hospital, it is €3,678.89, with an out-of-pocket share of about €1,104 (rates effective July 2025, excluding taxes). Depending on the center's tax rules, the amount may be higher. For private contract centers, our cost calculator therefore uses clinic-reported figures including value-added tax (VAT). In July 2026, Austria's family minister announced a reduction of the out-of-pocket share from 30% to 25%. It is not yet in the law (as of October 4, 2026).

Switzerland

Mandatory basic health insurance (Grundversicherung) pays for neither IVF nor ICSI. Only artificial insemination is covered, for a maximum of three treatment cycles per pregnancy, under Annex 1 of the Health Care Benefits Ordinance (Krankenpflege-Leistungsverordnung, KLV). You therefore pay for ICSI yourself, and prices including medications differ from clinic to clinic. Whether supplementary insurance contributes anything depends on the individual policy. Our cost calculator shows which amounts we use for Switzerland.

ICSI vs. IVF: when to choose which

Criterion IVF ICSI
Sperm quality Normal to slightly impaired Severely impaired
Fertilization Happens on its own in a culture dish Targeted microinjection
Fertilized per treated egg (D.I.R. 2024) 56.2% 66.4%
Fertilized per retrieved egg (D.I.R. 2024) 55.3% 52.5%
Cost Somewhat cheaper Somewhat more expensive (about 8.3% according to ESHRE)
Surgically retrieved sperm (TESE) Not usual Offer, according to NICE
Frozen eggs Rarely used Best-established method (ASRM)
Without male factor infertility Standard Not recommended according to ESHRE, ASRM, and NICE

The treatment team decides between IVF and ICSI based on the semen analysis, the medical history, and the individual situation. The decision aid in our article ICSI vs IVF shows which method guidelines recommend in which situation.

Risks

The risks of an ICSI treatment are essentially the same as those of IVF:

  • Ovarian hyperstimulation syndrome (OHSS): Severe OHSS (grade III) occurred in 0.2% of started stimulations in 2024, according to the German IVF Registry.
  • Complications during egg retrieval: in 0.6% of retrievals according to the registry, mostly vaginal bleeding
  • Multiple pregnancies: The multiple birth rate across all IVF, ICSI, and cryo treatments in 2023 was 8.0%. Among women with a good prognosis who had only one embryo transferred, it was 1.6% of live births.
  • Slightly increased risk of malformations: After assisted reproduction, the risk of congenital malformations is slightly increased. A 2026 meta-analysis found that among singletons, the risk was about 1.5 times as high after ICSI and about 1.3 times as high after IVF compared with natural conception. Overall, there was no significant difference between the two methods, but cardiovascular malformations were more common among singletons after ICSI than after IVF (HR 1.41). According to the G-BA guideline, the causes may lie in the procedures as well as in the infertility itself. Before ICSI for a male fertility disorder, the clinic must therefore also explain genetic risks and point out the entitlement to genetic counseling.

One risk specific to ICSI: During the injection, an egg can be damaged and then fail to develop further.

Frequently asked questions

Does ICSI always use just one sperm per egg?

Yes, exactly one. The embryologist selects the sperm with the best morphology and motility under the microscope and injects it in a targeted way.

Is ICSI more painful than IVF?

No. For the patient, the process is identical. The difference lies only in the lab step, which you do not notice.

Can ICSI be done with donor sperm?

Yes, technically that is possible. Donor sperm is stored frozen, but according to the authors of the Danish INVICSI trial, that alone is not a proven reason for ICSI. In this trial, about 27% of the participants used donor sperm, and overall ICSI did not lead to more births than conventional IVF. In Germany, treatment with donor sperm is not covered by statutory health insurance. The G-BA guideline allows only the eggs and sperm of the spouses.

How often do you have to repeat ICSI?

As with IVF, many couples need more than one transfer. In the Danish INVICSI trial (women in their first IVF cycle without severe male factor infertility), the first treatment cycle, including all frozen embryo transfers, led to a live birth in 43.2% of the women who received ICSI, and after the first transfer alone in 26.6%. The German IVF Registry also reports cumulative pregnancy rates across multiple transfers (Yearbook 2024). Your treatment team will advise you on your individual prognosis.

Conclusion

ICSI is the established method when sperm quality is severely impaired, when sperm were retrieved surgically, or when conventional IVF has led to no fertilization. Without male factor infertility, it offers no advantage according to large randomized trials, and ESHRE, ASRM, and NICE advise against it in that case. For you as a patient, the treatment proceeds exactly like IVF; only the fertilization step in the lab is different. Pregnancy rates per transfer are largely in line with those of IVF and depend mainly on age. The treatment team decides between IVF and ICSI based on the semen analysis and the medical history.

Sources

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